Effectiveness of A Health Microinsurance Scheme in Improving Health Equity and Clinical Outcomes for Private Primary Care in Kuala Lumpur, Malaysia
试验速览
- 阶段
- 不适用
- 入组人数
- 114
- 主要终点
- Health-seeking behavior
研究概览
简要总结
This is the Phase 3 of a 3 phase study to determine the feasibility, acceptability and effectiveness of a health microinsurance scheme in improving health equity and clinical outcomes for private primary care (PPC) in Kuala Lumpur, Malaysia. This two-arm, pre-post, quasi-experimental trial consisted of utilizing a HMI scheme (experimental clinic) and normal OOP payments (control clinic) for 6 months. The HMI scheme enabled subscribed households to access a defined benefit package at a selected PPC for treatment and follow-up.
详细描述
This will be a quasi-experimental study designed to determine the effectiveness of a community health microinsurance scheme (HMI) in private primary care clinics in Malaysia via a pre-post study of an experimental and control clinic. A proposed HMI scheme, whose price and benefit package have been defined through the earlier Phases 1 and 2, will be accessible to subscribed households at the experimental clinic, while the control clinic has subscribed patients paying as per normal practise, which is by Out-Of-Pocket payment. The HMI scheme enabled subscribers to visit the selected clinic chosen for any form of primary care diagnosis, treatment and follow-up. Both the clinics are located in the Jalan Ipoh area, a suburb of Kuala Lumpur, and have common sociodemographic characteristics. A pre-intervention questionnaire will aim to capture health seeking behaviour, delay in seeking medical care, monthly health expenditure and improvements in clinical outcome (assessed by clinical test results). After six months, a post-intervention questionnaire is administered again to the respondents which then allows assessment of the outcome variables.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Households were located in the study area
- •Method of payment to clinic is by out-of-pocket
- •This is household's regular choice of primary care provider.
- •Patient has been seen in the clinic since at least the past two years i.e from before Jan 1, 2014
排除标准
- •Households had members who died in the year
- •Households had members who were away from this place of residence for work/transferred for more than 1 month in
- •Households had members who had regular follow-up in public facilities for chronic disease.
- •Households with members who have switched methods of payment in the last year- (e.g newly bought insurance or retired and lost health benefits so paying OOP)
- •Patients who refuse consent
结局指标
主要结局
Health-seeking behavior
时间窗: Change from Baseline health seeking behavior at 6 months
Delays in seeking healthcare (days)
Monthly health expenditure
时间窗: Change from Baseline Monthly Health Expenditure at 6 months
How much has been spent for monthly health expenses (in Ringgit Malaysia)
次要结局
- Clinical Outcome of Diabetes Mellitus(Change from Baseline HbA1c at 6 months)
- Clinical Outcome of Hypertension(Change from Baseline Resting Mean Blood Pressure at 6 months)
- Clinical outcome of dyslipidemia(Change from Baseline serum cholesterol and LDL at 6 months)
- Clinical outcome of bronchial Asthma(Change from Baseline spirometry levels at 6 months)
研究者
Muralllitharan Munisamy
PhD Research Fellow
Chulalongkorn University